A successful resuscitation of a young man with tracheo-innominate artery fistula

Tracheo-innominate artery fistula is a rare but life-threatening complication of tracheostomy, even in chronic cases. A 22-year-old comatose man with a 2-year tracheostomy presented with sentinel bleeding followed by massive hemorrhage. Immediate measures included airway control, digital compression, and fluid resuscitation. Angiography confirmed a 3-mm fistula, and endovascular stenting achieved hemostasis. The patient was extubated on Day 5, with patent stent at 1-month follow-up but remained vegetative. Early recognition of sentinel bleeding and prompt endovascular intervention are critical for survival.